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Language Guiding Therapy: The Case of Dehydration versus Volume Depletion

Kevin Mange, MD; Dean Matsuura, MD; Borut Cizman, MD; Haydee Soto, MD; Fuad N. Ziyadeh, MD; Stanley Goldfarb, MD; and Eric G. Neilson, MD
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University of Pennsylvania Philadelphia, PA 19104 Grant Support: In part by grant DK-07006 from the National Institutes of Health and by the DCI RED fund. Drs. Mange, Matsuura, Cizman, and Soto are first-year renal fellows in the Renal-Electrolyte and Hypertension Division. Requests for Reprints: Eric G. Neilson, MD, Renal-Electrolyte and Hypertension Division, 700 Clinical Research Building, University of Pennsylvania, 415 Curie Boulevard, Philadelphia, PA 19104-6144. Current Author Addresses: Drs. Mange, Matsuura, Cizman, Soto, Ziyadeh, Goldfarb, and Neilson: Renal-Electrolyte and Hypertension Division, 700 Clinical Research Building, University of Pennsylvania, 415 Curie Boulevard, Philadelphia, PA 19104-6144. Acknowledgments: The authors thank Dr. Richard Tannen, Professor and Vice-Dean for Research at the University of Pennsylvania, for critically reading this manuscript. Current Author Addresses: Drs. Mange, Matsuura, Cizman, Soto, Ziyadeh, Goldfarb, and Neilson: Renal-Electrolyte and Hypertension Division, 700 Clinical Research Building, University of Pennsylvania, 415 Curie Boulevard, Philadelphia, PA 19104-6144.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1997;127(9):848-853. doi:10.7326/0003-4819-127-9-199711010-00020
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Patients presenting with orthostatic hypotension and normal plasma sodium concentrations are frequently admitted to the hospital with a diagnosis of dehydration. If they are fortunate, they receive fluids containing sodium chloride instead of free water to correct obvious extracellular fluid volume depletion. Confusing this diagnosis highlights the growing and pernicious habit of using the terms dehydration and volume depletion interchangeably at the bedside when the two describe clearly different disturbances.

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